台灣腦中風急性後期照護品質之復健治療照護效益分析

Assessment on the stroke rehabilitation benefit of Post-acute Care in Taiwan

吳心怡(Hsin-Yi Wu)

指導教授 ： 白佳原

中山醫學大學/健康管理學院/醫療產業科技管理學系碩士班/碩士(2017年)

摘要

臨床上愈來愈多的腦中風病患，在急性醫療後可能出現失能情形，將大幅造成對醫療體系、家庭及社會照顧之負擔或依賴。目前因臨床上很少研究探討衛生福利部中央健康保險署於103年試辦，「全民健康保險提升急性後期照護品質試辦計畫-以腦中風為例(Post-acute Care -Cerebrovascular Diseases)簡稱PAC-CVD」之復健治療照護效益評估，所以才進行此研究。本篇研究採取參加急性後期照護之腦中風患者來分析，收集自103年1月1日至105年12月31日的患者。以整體功能狀態(Modified Rankin Scale, MRS)為收案標準，收集（1）基本資料：年紀、性別、病史（2）巴士量表(Barthel Index)（3）吞嚥進食功能(Functionnal Oral Intake Scale, FOIS) (4)營養評估(Mini Nutrition Assessment, MNA) (5)健康相關生活品質評估(EuroQoL-5D, EQ-5D) (6) 工具性日常生活功能(Lawton-Brody IADL Scale, IADL) (7)伯格氏平衡量表(Berg Balance Test)(8)行走速度(Usual Gait Speed) (9)六分鐘行走測試(Six Minute Walk Test, 6MWT) (10)博格梅爾評估量表(Fugl-Meyer Assessment) (11)認知、知覺功能評估(Mini-Mental State Examination, MMSE) (12)職能表現/(13)動作活動日誌(Motor Activity Log) (14)簡明失語症測驗(Concise Chinese Aphasia Test, CCAT)。利用配對T檢定、獨立樣本T檢定、One Way ANOVA及皮爾遜相關統計探討個變性的關連性。

關鍵字

腦中風 ； 急性後期照護

並列摘要

There are significantly increase clinical stroke patients arise in the acute medical disability, and this will cause a substantial burden on the health care system, both for family and social care. Currently very rare clinical study was conducted to investigate the project-Ministry of Health and Welfare Department's Central Health Insurance pilot in the 103 years, "National Health Insurance to enhance the quality of post-acute care pilot project - Case Study in Stroke (Post-acute Care -Cerebrovascular Diseases) referred to rehabilitation therapy care benefit assessment PAC-CVD , that is the reason to conduct this study.
This research take post-acute stroke patients to analyze, the patients were from January 1, 2014 to December 31, 2016. The overall functional status (Modified Rankin Scale, MRS) were collected, also include (1) Basic information: age, sex, medical history (2) Barthel Index (3) Functional Oral Intake Scale (FOIS) (4) Mini Nutrition Assessment (MNA) (5) EuroQoL-5D (EQ-5D) (6) Lawton-Brody IADL Scale (7) Berg Balance Test (8) Usual Gait Speed (9) Six Minute Walk Test ( 6MWT) (10) Fugl-Meyer Assessment (11) Mini-Mental State Examination (MMSE) (12)/(13) Motor Activity Log (14) Concise Chinese Aphasia Test (CCAT). Regression analysis was used to explore the data collected on above and prognosis of connection can be used as a post-acute stroke care quality of rehabilitation therapy care, plans to close the case in standard stringency and rehabilitation in increase or decrease the treatment days of the reference index.
Paired T test, independent sample T test, One Way ANOVA and Pearson correlation statistics were used to explore the relevance of all variable.

並列關鍵字

Stroke ； Post-acute Care

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